Odd Couples

Herbal supplements can interfere with dental meds

By Julie Flaherty

Oil and water. Superman and kryptonite. Some things just don’t mix. Even dentistry has some pairings that should be avoided.

According to a report in the Journal of the American Dental Association, there are four common dietary supplements dentists should look out for when treating their patients: St. John’s wort, gingko, valerian and evening primrose. The authors say those herbals are the most likely to create adverse interactions with the drugs frequently prescribed during dental treatment.

Because ginko and evening primrose can interact with aspirin and ibuprofen, the authors suggest acetaminophen as the preferred painkiller. St. John’s wort and valerian interact with most of the commonly used sedatives. For those patients, the safest alternative may be nitrous oxide-oxygen.

Carole Palmer, G69, professor and head of the division of nutrition and oral health promotion, teaches Tufts’ first-year dental students about nutrition and supplements. She says that most lists of drug interactions are not geared toward dentists, which makes this targeted list useful and a great way to raise awareness.

Of course, finding out what supplements patients use can take some work. One third of Americans report taking dietary supplements, but many of them aren’t sharing that information with their health-care providers. In one National Institutes of Health survey, 42 percent of people age 50 and older said their doctors didn’t ask them about complementary and alternative medicine, and 30 percent said they did not know that they should bring it up.

“When you ask the patient what they are eating, they won’t tell you about supplements,” Palmer warns. “You have to ask that question separately.”

Only then can dentists get down to the nitty gritty of avoiding bad combos. Some, like toothpaste and orange juice, patients will just have to discover on their own.